The Effect of a High‐Intensity Functional Exercise Program on Activities of Daily Living: A Randomized Controlled Trial in Residential Care Facilities

Abstract

A high-intensity functional weight-bearing exercise program seems to reduce ADL decline related to indoor mobility for older people living in residential care facilities. The program does not appear to have an overall effect on ADLs. In people with dementia, the exercise program may prevent decline in overall ADL performance, but continuous training may be needed to maintain that effect.

Systematic review of functional training on muscle strength, physical functioning, and activities of daily living in older adults

“…Seven trials recruited older adults aged 70 years or above [17,12,47,11,8,18,21]. Three trials recruited older adults from either congregate housing or long-term care facilities [17,1,31]. Five studies specifically recruited older adults with some degree of difficulty or dependency in mobility or ADL [1,31,35,47,18].…”

“…Three trials recruited older adults from either congregate housing or long-term care facilities [17,1,31]. Five studies specifically recruited older adults with some degree of difficulty or dependency in mobility or ADL [1,31,35,47,18]. Three trials exclusively recruited women [9,47,11].…”

“…Four trials enrolled more than 100 participants [1,31,51,8]. The adherence rates in two trials were lower than 70 % [8,21].…”

“…Cress et al used a twogroup nonrandomization design [9]. Six trials applied a two-group randomized controlled trial design: three trials compared functional training to an attention placebo control group [17,31,18]; one trial compared functional training to a control group who engaged in flexibility exercises [1]; one trial compared two programs that differed in functional training dosage, home exercise versus combined home and group exercise [21]; and one trial compared functional training to strength training [28]. Among three trials that applied a three-group randomized controlled trial design, in addition to a functional training group: two trials included a strength training group [35,11]; two trials included a control group [11,8]; one trial included a strength plus functional training group [35]; and one trial included a strength plus balance training group [8].…”

“…Chin A Paw et al used game-like and cooperative activities such as throwing and catching a ball as functional training activities [7], while other studies were more focused on exercises simulating locomotor ADL such as walking, stair climbing, or chair stands [9,17,1,12,31,35,47]. Still, other researchers included modified ADL tasks in the functional training component, such as dressing, laundry, vacuuming, or carrying groceries [12,35,11].…”